Individual provider Active NPI

Antonio C De Andrade, M.D.

  • Hospice and Palliative Medicine (Surgery) Physician
  • Altamonte Springs, FL
National Provider Identifier
1972508562
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Surgery) PhysicianTaxonomy code 2086H0002X
License
ME101361 Issued in FL
Practice address
480 W Central Pkwy
Altamonte Springs, FL 32714-2415
Phone
(407) 683-0808
Fax
(407) 379-0511
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Surgery) Physician 2086H0002X ME101361 FL Primary

Addresses

Primary practice location

480 W Central Pkwy
Altamonte Springs, FL 32714-2415

Mailing address

2100 Hestia Loop Apt 538
Oviedo, FL 32765-9569
Phone (407) 921-9953

Other practice location 1

600 N US Highway 17 92 Ste 124
Longwood, FL 32750
Phone (407) 876-6699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240612000436 FL Order and Referring Only - Hospice/Palliative CarePractitioner - Hospice/Palliative Care 0840252375

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME101361FLMDHospice and Palliative Medicine (Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ear, Nose & Throat Associates of Corpus Christi Current Accepting new patients
Adventhealth Home Health and Hospice Inc PastSince Sep 4, 2022 Accepting new patients

Locations

5959 S Staples St
Ste 102
Corpus Christi, TX 78413
Phone (361) 500-4949

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AFAJBA

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1972508562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 HESTIA LOOP APT 538",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327659569",
            "telephone_number": "407-921-9953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 W CENTRAL PKWY",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142415",
            "telephone_number": "407-683-0808",
            "fax_number": "407-379-0511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 N US Highway 17 92 Ste 124",
            "address_purpose": "LOCATION",
            "city": "Longwood",
            "state": "FL",
            "postal_code": "32750",
            "country_code": "US",
            "telephone_number": "407-876-6699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE ANDRADE",
        "first_name": "ANTONIO",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086H0002X",
            "taxonomy_group": "",
            "desc": "Surgery, Hospice and Palliative Medicine",
            "state": "FL",
            "license": "ME101361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

Verify at the official NPI Registry.